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The most common form of B12 that youll find everywhere is cyanocobalamin and it is not very active or beneficial to the body because the absorption rate is fairly low, thats because the body has to convert it first into Hydroxy B12, and from there the Hydroxy B12 has to be converted into both adenosylcobalamin and Methylated-B12. But if the body has genetic mutations then these conversions dont happen well at all and the effect is the body does not get the absorption or use of the nutrient

This is standard medical advice for gastric distress from Johns Hopkins Medicine

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J Diabetes 2017;9:320-4